Chronic Arthritis and Its Treatment

Nissen, H. Archibald

doi:10.1056/nejm193405242102104

Cited by 10 publications

(1 citation statement)

References 6 publications

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“…The tension which resulted from this situation was in fact released in a regressive physical way through general restlessness, travelling about, and neurotic neuro-muscular reactions." Nissen (1934) states that 22 per cent. of 500 cases of arthritis could be classed definitely as having had sufficient emotional strain preceding the arthritic onset to warrant its being considered as an aetiological agent; while Jelliffe and White (1935) say: " The psychogenic discipline is also commencing to show that purely emotional reactions extend deep down in the individual's metabolic processes.…”

Section: Psychogenic Rheumatismmentioning

confidence: 99%

Psychological Factor in Rheumatism

Gordon¹

1939

BMJ

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Chronic rheumatic diseases comprise a complex group of conditions-which are very common, very disabling, and by no means easy to treat. A great deal has been written about them, but there is no unanimity yet as to their interrelationship, their pathology, or their treatment. Roughly these diseases may be divided into four main groups-rheumatoid arthritis, osteo-arthritis, fibrositis, and, standing rather apart, gout.It is generally held that in the rheumatoid group the most important pathogenic factor is infection, probably by one o-r other strain of streptococcus. In the osteoarthritic group degenerative and arteriosclerotic factors are most significant; in fibrositis infection is considered to play an important part in the younger victims, and metabolic and degenerative changes in the older subjects; while in gout there is almost certainly a hereditary factor which governs, the metabolic changes that characterize the attack.In the rheumatoid group we have a condition that many would call "true rheumatoid," in which, while infection is almost certainly of great importance, nevertheless it is difficult to determine its exact source. A few years ago great play was made with the shibboleth of focal infection, yet in a recent communication Cecil and Angevine (1938) (Aschoff, 1938) must not be forgotten, while dietary factors and avitamincsis must not be lost sight of (Abrams and Bauer, 1938).' It is obvious from these consid0ratioris that no one factor is going to prove responsible for Xthe.-various forms of chronic rheumatic diseases, anr,' if we-turn our attention in any pa'rticular dire'ction il mustCbe clearly understood that the factor under discussion is only contributory to the formation of the total picture, and is in no sense to be regarded as the sole or even the major causal agency. The subject of this paper, then, is how far the result iof emotional disturbance may contribute to the picture of ichronic rheumatic.disease. In dealing with the effects of emotional disturbance on the function of the body it is ,necessary to divide the effects into two groups.The first of these consists of those changes produced through abnormal action of the autonomic system on the 'circulatory and secretory organs and on the tone of plain 'muscles. Wittkower (1935)

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Section: Psychogenic Rheumatismmentioning

confidence: 99%